Erythropoiesis-independent effects of iron in chronic kidney disease.
Erythropoiesis-independent effects of iron in chronic kidney disease.
复制标题
铁在慢性肾病中的红细胞生成独立作用。
DOI：
10.1007/s00467-021-05191-9
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Akchurin,Oleh
中科院分区：
文献类型：
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作者：
Patino,Edwin;Akchurin,Oleh
慢性肾脏病（CKD）导致铁代谢的改变，这有助于贫血的发展，并需要在CKD患者中补充铁。升高的铁调素导致CKD中显著的铁再分布。最近的数据表明，这些铁稳态的改变加上治疗性补铁对CKD患者的许多器官系统具有多效性作用，远远超出了铁的传统血液学作用;这些包括铁对炎症、氧化应激、肾纤维化、心血管疾病、CKD-矿物质和骨骼疾病以及儿童骨骼生长的影响。铁补充剂的效果似乎在很大程度上取决于给药途径和特定的铁制剂。铁基磷结合剂增加了铁用于传统（贫血）和新型（高磷血症）适应症的机会。进一步优化CKD患者的铁治疗可能会为治疗CKD并发症提供新的方法，并可能改变疾病进展。
Chronic kidney disease (CKD) leads to alterations of iron metabolism, which contribute to the development of anemia and necessitates iron supplementation in patients with CKD. Elevated hepcidin accounts for a significant iron redistribution in CKD. Recent data indicate that these alterations in iron homeostasis coupled with therapeutic iron supplementation have pleiotropic effects on many organ systems in patients with CKD, far beyond the traditional hematologic effects of iron; these include effects of iron on inflammation, oxidative stress, kidney fibrosis, cardiovascular disease, CKD-mineral and bone disorder, and skeletal growth in children. The effects of iron supplementation appear to be largely dependent on the route of administration and on the specific iron preparation. Iron-based phosphate binders exemplify the opportunity for using iron for both traditional (anemia) and novel (hyperphosphatemia) indications. Further optimization of iron therapy in patients with CKD may inform new approaches to the treatment of CKD complications and potentially allow modification of disease progression.